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Locum Tenens: using a Medicare Barred MD

Hello,
I have a strange situation and I am not confident in my stance.
Medicare’s regulations are not specific to this situation from everything I have read.

The Locum Tenen (Fee for compensation) Arrangement:

So, my provider was out, brought in this locum and has a valid license.
However, the acting locum "substitute" provider has been barred to re-enroll with Medicare until a much later date.
I know we are not enrolling this provider, but I felt strange about this.

I was concerned about the barred re-enrollment meaning they could not be a substitute for a Medicare Covered Service despite this being filed under my provider’s credentials.

Should we be okay to proceed in billing this service under the locum tenen arrangement?

Am I being paranoid?:o

Thank you for your feedback!
~Melissa, CPC

Medical Billing and Coding Forum

Locum Tenens & Place of Service

Hello,
I need guidance in regards to Locum Tenens billing. Here is the the scenario

1) Hospital Base Pathology Group
2) Services are rendered at ABC Hospital. They also have specimens from another hospital (123 Hospital) sent to ABC to be processed.
3) One Pathologist Leaves
4) A Locum Tenens was hired to perform the work for the provider who left however; only for the work that comes from the other hospital (123 Hospital)
5) The Locum does not have hospital privileges at ABC Hospital and that is why specimens were instead shipped to AAA Hospital to be processed.
(Note: The Locum has his personal business at AAA hospital, but does not want this temporary work to be mixed into his business.)

Question:
a) Is this Locum arrangement even valid?
b) Can we use the Pathologist who left add Q6 modifier and bill under AAA Hospital location since that is where it’s being processed?

We have been told to use the ABC hospital location where the group is and Pathologist left from.. But I don’t think this is right. The Locum is not there working at that facility.

I tried finding this on the CMS manuals, but unable to find specific verbiage to support why it shouldn’t be done this way.

Thank you,
GZ

Medical Billing and Coding Forum

Changes to Reciprocal Billing and Locum Tenens Arrangements

As a result of the “21st Century Cures Act” (P.L. 114-255), reciprocal billing arrangements and locum tenens arrangements will apply not only to physicians but to physical therapists (specialty code 65) who work in certain health professional shortage areas.  With the passing of this law, both reciprocal billing arrangements and locum tenens arrangements are applicable to Medicare-enrolled […]
AAPC Knowledge Center

Locum Tenens Basics

Locum tenens is a Latin phrase that means, “to hold the place of.” In medicine, locum tenens are contracted physicians who substitute for a physician who has left the practice, or who is absent or otherwise unavailable. The Centers for Medicare & Medicaid Services (CMS) allows payment to the regular physician for services provided during […]
AAPC Knowledge Center